N522PE-20A Module 1 Assignment 1 Clinical Reasoning

Discussion 1

Post to the discussion board a planned approach to communicating with someone who speaks another language. What type of questions will you need to ask? Was there any communication issues discussed this week in Shadow Health? How does communication impact the concept of clinical reasoning in nursing? Please discuss the issues completely, citing your sources so that your classmates can reference the information. Include one insight gained this week from your readings or interaction in Shadow Health. N522PE-20A Module 1 Assignment 1 Clinical Reasoning

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria.

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Robert Toledo N522PE Discussion 1 Example Approach and Responses

It always difficult to give appropriate care when there is a communication gap. Because of inaccurate understanding or interpretation of a patient’s own diagnosis, higher levels of psychological distress occurs which can lead to healthcare disparities (Hyatt, et al., 2016).

In the hospital I am employed at, once we determine the patient’s main language and whether they speak any English, we use an interpreter phone system to translate even if there are nurses that speak the same language. As per Bickley (2017), it is safer and the most accurate to use an interpreter and also, speak clearly in order to have the most correct interpretation.

Furthermore, the type of questions that need to be asked should be clear and concise such as: What is the reason that you are coming to the hospital? Or can you describe your main concern that has brought you here?

Effective communication is important in clinical reasoning, as it allows increased levels of patient satisfaction, through self-management of patient health needs It enables nurse practitioners (NP) to recognize the severity of patients’ conditions (Barrett, 2019). .

The Shadow Health program allows the continued practice of such communication and clinical reasoning. It discusses starting conversations with open ended questions, and allowing the patient to elaborate and then move on to yes/ no question using clear and concise questions during the initial interview (Barrett, 2019).

In conclusion studies suggest that peoples’ requirements and expectations differ from each other, and health literacy and education play a role in lower health outcomes. To combat this health interventions should be specific to the cultural groups’ needs in order to provide quality care across the patient spectrum (Hyatt, et al., 2016).

References

Bickley (2017). Bates’ Guide to Physical Examination and History Taking (Twelfth, North American ed.). LWW.

Barratt J. Developing clinical reasoning and effective communication skills in advanced practice. Nurs Stand. 2018 Dec 24. doi: 10.7748/ns.2018.e11109. Epub ahead of print. PMID: 31468880.

Hyatt, A., Lipson-Smith, R., Schofield, P., Gough, K., Sze, M., Aldridge, L., Goldstein, D.,Jefford, M., Bell, M. L., & Butow, P. (2017). Communication challenges experienced by migrants with cancer: A comparison of migrant and English-speaking Australian-born cancer patients. Health expectations: an international journal of public participation in health care and health policy, 20(5), 886–895. https://doi.org/10.1111/hex.12529

390 words N522PE-20A Module 1 Assignment 1 Clinical Reasoning

Robert –
I traveled to Tibet through a grant program to learn and educate the Tibetan Nuns on their woman’s health issues and hygiene practices. Our Tibetan host served as our interpreter to translate for us during one part of our trip. In the second part of our journey, we used a nurse who worked in a Chinese hospital but fluent in Tibet and Chinese languages. Once the nurse joined us on our trip, it was amazing to see the difference in the eagerness of the Tibetan nuns to learn from us.

Having experienced being in a foreign language where I did not understand the language, culture, or customs was scary on some levels. If I had needed hospitalization in China, I don’t know if somebody would have provided me with an English interpreter.

The Department of Health and Human Services has established guidelines for competencies required for one to be a “qualified interpreter” (Department of Health and Human Services, 2016). Interpreters must have the skills to understand medical terminology, maintain confidentiality, and HIPAA guidelines, and interpret conversations effectively, impartially, and accurately (DHHS, 2016).

Currently, hospital interpreters are not required to hold a national certification. Do you think this should be a requirement?

Department of Health and Human Services [DHHS] (2016). Nondiscrimination in health programs and activities: final rule. Federal Register, 81(96):31375-31473. https://www.govinfo.gov/content/pkg/FR-2016-05-18/pdf/2016-11458.pdf

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Hello Robert!

I wanted to commend you on noting that a translator is always preferred, even if there is a Nurse that speaks the same exact language.At my hospital we have the same exact approach towards communication to the patient, the methods ensures that no errors are made.

Barratt J. Developing clinical reasoning and effective communication skills in advanced practice. Nurs Stand. 2018 Dec 24. doi: 10.7748/ns.2018.e11109. Epub ahead of print. PMID: 31468880.

Turnitin ID: 1398144547

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In the hospital that I work at establishes what language the patient speaks during the time the appointment is made. The scheduling department tries to have the language that the patient speaks already in the computer and whether the patient will need a translator during the appointment. Communication is important when completing an assessment and learning about the patient. Patients need to be able to ask questions and understand exactly what the doctor is explaining to them about their diagnoses.

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Hi Robert,
When I first started working as a nurse in the USA, I remember being asked by my coworkers to talk to Spanish speaking patients after they heard me talking to a patient in Spanish. I took Spanish in college and could still carry on simple conversations. What I found hilarious however was that sometimes they would ask me to talk to someone who, to my coworker’s ears sounded like speaking in Spanish would actually be Greek, or Italian or some other language.
I am not qualified to translate in Spanish, and I never really did. I just helped with simple instructions pertaining to doing something related to their care. It is very important for translators to be certified for they need to be able to translate through medical terminologies. Just knowing the language may not be enough. Nurses need to be culturally competent, and should be able to tailor their communication to the patient’s health need and learning ability. A clinician needs to get as much information about the patient. A good source of information which could give you a better picture of the patient are the charts from previous assessments and admissions.

Reference

Diamond, L., Izquierdo, K., Canfield, D., Matsoukas, K., & Gany, F. (2019). A systematic review of the impact of Patient–Physician non-english language concordance on quality of care and outcomes. Journal of General Internal Medicine, 34(8), 1591-1606. doi:http://dx.doi.org.americansentinel.idm.oclc.org/10.1007/s11606-019-04847-5

243 words N522PE-20A Module 1 Assignment 1 Clinical Reasoning

Assignment 1

Assignment Instructions:

Write a three-page paper on the use of clinical reasoning in developing and applying advanced health history and physical assessment skills at the graduate level. Consider contemporary nursing literature on the development of clinical reasoning and decision-making. How does the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level. Please use the submission parameters and rubric below to guide you when completing this assignment.

Submission Parameters:

For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 3 pages, which does not include the cover page and reference page(s).

I. Introduction (including purpose statement)

II. Clinical Reasoning

Describe how clinical reasoning is used in developing and applying advanced health history and physical assessment skills at the graduate level.

III. Nursing Process

Describe how the use of the nursing process enhance critical thinking, clinical reasoning, and clinical judgment in professional nursing practice at the graduate level.

IV. Clinical Example

Discuss an example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning.
Discuss how nursing care is provided when each of these concepts are evidenced in nursing care of the patient.

V. Conclusion

VI. References (consider contemporary nursing research studies or reliable electronic sources)

In regards to APA format, please use the following as a guide:

Include a cover page and running head (this is not part of the 3 pages limit)
Include transitions in your paper (i.e. headings or subheadings)
Use in-text references throughout the paper
Use double space, 12 point Times New Roman font
Apply appropriate spelling, grammar, and organization
Include a reference list (this is not part of the 3 pages limit)
Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP)

Assignment 1 Rubric – N522PE-20A Module 1 Assignment 1 Clinical Reasoning

Assignment 1 Rubric
Competency

Points

Define, compare and contrast clinical reasoning and decision-making. How is this related to critical thinking and clinical judgment in graduate level nursing practice?

Defines, compares, and contrasts clinical reasoning and decision-making with cited references in addition to course readings for Week 1.
Answers posed questions.

Defines, compares, and contrasts clinical reasoning and decision-making with cited references from course readings for Week 1.
Answers posed questions.

Describes clinical reasoning and decision-making. Briefly answers how is this related to critical thinking and clinical judgment in graduate level nursing practice?

Does not define, compare and contrast clinical reasoning and decision-making. Does not answer how is this related to critical thinking and clinical judgment in graduate level nursing practice?

/30

Consider contemporary literature and apply the concept of clinical reasoning to advanced physical assessment in nursing.

Considers contemporary literature and applies the concept of clinical reasoning to advanced physical assessment in nursing.

Considers textbook literature and references within text book without further consideration of external literature support.

Considers and applies concept of clinical reasoning to advanced physical assessment in nursing without reference to expert opinion or research literature. N522PE-20A Module 1 Assignment 1 Clinical Reasoning

Does not consider and apply concept of clinical reasoning to advanced physical assessment in nursing.

/30

Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. How is nursing care provided or modified when each of these concepts are evidenced in nursing care of the well-adult, family, and one special population?

Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, and one special population.

Demonstrates the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Discusses how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population.

Does not demonstrate the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Does not discuss how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population.

/30

APA Format, grammar, punctuation and spelling.

APA Format, grammar, punctuation and spelling is accurate with no errors.

APA Format, grammar, punctuation and spelling is accurate with less than two types of errors.

APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors.

APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. N522PE-20A Module 1 Assignment 1 Clinical Reasoning

/10

Competency	30	27	25	0	Points
Define, compare and contrast clinical reasoning and decision-making. How is this related to critical thinking and clinical judgment in graduate level nursing practice?	Defines, compares, and contrasts clinical reasoning and decision-making with cited references in addition to course readings for Week 1. Answers posed questions.	Defines, compares, and contrasts clinical reasoning and decision-making with cited references from course readings for Week 1. Answers posed questions.	Describes clinical reasoning and decision-making. Briefly answers how is this related to critical thinking and clinical judgment in graduate level nursing practice?	Does not define, compare and contrast clinical reasoning and decision-making. Does not answer how is this related to critical thinking and clinical judgment in graduate level nursing practice?	/30
	30	27	25	0
Consider contemporary literature and apply the concept of clinical reasoning to advanced physical assessment in nursing.	Considers contemporary literature and applies the concept of clinical reasoning to advanced physical assessment in nursing.	Considers textbook literature and references within text book without further consideration of external literature support.N522PE-20A Module 1 Assignment 1 Clinical Reasoning	Considers and applies concept of clinical reasoning to advanced physical assessment in nursing without reference to expert opinion or research literature.	Does not consider and apply concept of clinical reasoning to advanced physical assessment in nursing.	/30
	30	27	25	0
Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. How is nursing care provided or modified when each of these concepts are evidenced in nursing care of the well-adult, family, and one special population?	Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, and one special population.	Provides one clinical example demonstrating the nurse’s use of critical thinking, clinical judgment, and clinical reasoning. Discusses how nursing care was provided or modified when each of these concepts were evidenced in nursing care of the well-adult, family, or one special population.	Demonstrates the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Discusses how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population.	Does not demonstrate the nurse’s use of critical thinking, clinical judgment, or clinical reasoning. Does not discuss how nursing care was provided or modified when these concepts were evidenced in nursing care of the well-adult, family, or one special population.	/30
	10	9	8	0
APA Format, grammar, punctuation and spelling.	APA Format, grammar, punctuation and spelling is accurate with no errors.	APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. N522PE-20A Module 1 Assignment 1 Clinical Reasoning	APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors.	APA Format, grammar, punctuation and spelling is accurate with more than five types of errors.	/10

N522PE-20A Module 1 Assignment 1 Clinical Reasoning